--- title: Are stress and personality traits linked to PMS and PMDD? | Niyora description: Yes. Women with high stress or high neuroticism (a tendency toward worry and negative feelings) were 5 to 8 times more likely to have PMS or PMDD. This is fai url: https://niyora.com/research/papers/psychological-factors-and-premenstrual-syndrome-a-spanish-case-control-study-2019/ --- - [Niyora](https://niyora.com/) - [Research](https://niyora.com/research/) - [Library](https://niyora.com/research/library/) - Are stress and personality traits linked to PMS and PMDD? Non-randomised trial, 2019 # Are stress and personality traits linked to PMS and PMDD? Yes. Women with high stress or high neuroticism (a tendency toward worry and negative feelings) were 5 to 8 times more likely to have PMS or PMDD. This is fairly reliable because it compared women with the condition to similar women without it. Moderate study design 285 women with PMS, 88 with PMDD, and matched controls from Spanish public hospitals ## What they did Case-control study in Spain. Researchers compared 285 women with PMS and 88 women with PMDD against matched controls without these conditions. They measured perceived stress, neuroticism, and coping strategies using questionnaires. ## What they found Medium stress increased odds of PMS by 2.49 times and PMDD by 2.61 times. High stress increased odds of PMS by 4.90 times and PMDD by 5.79 times. Medium neuroticism increased odds of PMS by 2.53 times and PMDD by 3.70 times. High neuroticism increased odds of PMS by 8.05 times and PMDD by 5.73 times. High levels of most coping strategies were also linked to increased odds. ## What it means for you Stress and personality are strongly linked to PMS and PMDD, but the study cannot prove whether stress causes symptoms or symptoms cause stress. The finding that coping strategies increased risk suggests the connection is complex. 4.90 Times higher odds of PMS with high stress 5.79 Times higher odds of PMDD with high stress 8.05 Times higher odds of PMS with high neuroticism ## About the study Original title Psychological factors and premenstrual syndrome: A Spanish case-control study Authors Del Mar Fernández M, Regueira-Méndez C, Takkouche B Journal PloS one Year 2019 Study design Non-randomised trial Participants 88 What was tested None - observational study Open access Yes Read the paper [doi.org/10.1371/journal.pone.0212557](https://doi.org/10.1371/journal.pone.0212557) Original abstract Objective: To assess whether the psychological variables perceived stress, neuroticism and coping strategies, are associated with Premenstrual Syndrome (PMS) and Premenstrual Dysphoric Syndrome (PMDD). Design: Case-control study with incident cases using the Spanish public healthcare system. Setting: 3 major public hospitals and one family counseling and planning center. Population: Women consulting for troubles related to menstruation and for other motives such as screening for uterine cancer, contraception counselling or desire for pregnancy. Methods: Logistic regression. Main outcome measures: Odds of PMS and PMDD. Results: 285 PMS and 285 age-matched controls, as well as 88 PMDD cases and 176 controls participated in the study. Medium and high levels of perceived stress were associated with an increase in the odds of PMS (Odds Ratio (OR) = 2.49; 95%CI: 1.41-4.39 and OR = 4.90; 95%CI: 2.70-8.89, respectively). For PMDD the results were: OR = 2.61; 95%CI: 1.35-5.05 and OR = 5.79; 95%CI: 2.63-12.76, respectively. Subjects with medium and high levels of neuroticism were also at higher odds of suffering from PMS (OR = 2.53; 95%CI: 1.06-6.06 and OR = 8.05; 95%CI: 3.07-2.12, respectively). For PMDD, the results were OR = 3.70; 95%CI: 1.27-10.77 and 5.73: 95%CI: 1.96-16.77, respectively. High levels in the large majority of coping strategies were also associated with increased odds of PMS and PMDD. Conclusions: Psychological factors including perceived stress, neuroticism and coping strategies are strongly related to PMS/PMDD. This association is unlikely to be due to confounding or misclassification bias. A reverse causation process cannot be ruled out although its likelihood is remote. Reproduced under CC-BY. ## Topics [Premenstrual syndrome (PMS)](https://niyora.com/research/topics/condition-pms/)[Premenstrual dysphoric disorder (PMDD)](https://niyora.com/research/topics/condition-pmdd/)[Low mood and depression](https://niyora.com/research/topics/symptom-depression-mood/)[Stress](https://niyora.com/research/topics/symptom-stress/)[Psychotherapy, counselling and education](https://niyora.com/research/topics/treatment-psychotherapy/) Research tells you what helps on average. Niyora helps on the day it hits. Calm down, see it another way, and decide what to say, with a PMS and PMDD app built by a doctor. ## Related studies Review, 2023 What treatments help mental and physical health problems linked to the menstrual cycle? Survey study, 2026 How common is PMDD among female medical students and what triggers it? Cohort study, 2025 Do pain sensitivity and negative thinking explain how trauma and stress cause PMS or PMDD? 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